Health Plan needs political consensus and necessary funding

Dr. Manmohan Singh has announced in his Independence Day speech that the NRHM would be converted into a National Health Mission.

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Dinesh C Sharma

New Delhi

August 16, 2012

UPDATED: August 16, 2012 12:54 IST

Public healthcare care system needs strengthening, not gambles like public-private partnership.

It is unfortunate that health hits headlines mostly for wrong reasons scams in National Rural Health Mission(NRHM), womb removal for cornering insurance money, cases of medical negligence and so on.

The public discourse that follows such incidents is usually episodic and bereft of any serious discussion on the state of health in the country.

The blueprint for universal health coverage(UHC), which the high level expert group led by Dr K. Srinath Reddy had unveiled in December last year, provided an opportunity to discuss all aspects of India's health system for once.

This would have enabled us to embark upon a new path in the 12th plan. Sadly, this opportunity has been withered away and we appear to be back on the same old Planning Commission track a larger role for corporate, market-based health delivery system as the only solution to health woes of poor Indians.

Logically, we should have had a national debate on UHC threadbare after the report was submitted.

This should have been led by the Prime Minister himself because he had set up the high profile expert group. To be fair, Dr. Manmohan Singh did flag off the issue and committed himself to a strong public health system by proposing to hike public spending to 2.5 per cent of the GDP.

Consensus building within the government should have followed this but the opposite took place.

The Planning Commission started haggling on the issue and pegged the increase to a mere 1.5 per cent of the GDP during the next five years. The pretext was that the public system may not be able to absorb a large increase and that the economy was slowing down.

Instead of strengthening the public system, as desired by the PM, smart officials in the commission want to promote Western-style managed care system where public and private health networks compete.

The corporate hospital lobby wants the state to take care of only primary health care, leaving secondary and tertiary healthcare to them. To say the least, the idea is not just absurd but dangerous.

Thankfully, the health ministry has also decided to oppose it. The health of a billion plus people is too precious to be left to the whims of a few officials of the Planning Commission. We need a wider consultation both within and outside the government.

Building political consensus on health is necessary. NRHM scam in Uttar Pradesh has shown how good intentions can turn into a money-making machine for the crooked if the political leadership in a state is not committed to public health.

The health plan must be formally circulated among all political parties and state governments to elicit their views.

This would force them to take a formal stand. Health should be a consensus-based priority with all states on the same page. After all, health is also a state subject and much depends on them.

The direction of the health plan should be made clear. In my view, the thrust for the next five years should be to strengthen the public health system.

The 12th plan can be a turnaround plan for it. The PM has announced in his Independence Day speech that the NRHM would be converted into a National Health Mission.

This is welcome provided it is intended to revive the public system and is not implemented through marketbased solutions such as cash transfers or public-private partnerships.

All that we need is political commitment, unconditional support and necessary funding. Don't junk the public system in favour of private care without giving it an opportunity to revive itself.

Physical inactivity is indeed sickening

We are often told that a sedentary lifestyle is a common cause of obesity, which in turn is considered a risk factor for diabetes, high blood pressure and heart disease.

Now a health expert says physical inactivity or lack of exercise by itself should be treated as a disease or medical condition.

It may sound an overstatement, but Michael Joyner of Mayo Clinic says physical inactivity has serious manifestation not just among the obese but also people with normal weight such as those doing desk jobs. Our bodies get deconditioned if we don't exercise for long.

This results in several structural and metabolic changes heart rate may rise excessively during physical activity, bones and muscles may get wasted, physical endurance wanes and blood volume declines.

"Physical inactivity is the root cause of many common problems that we have and may have to be treated the same way as smoking addiction," Joyner argues in a commentary published in The Journal of Physiology. However, in order to 'treat' physical inactivity you don't have to join a rehab or even a gym.

Joyner says build as much activity as possible into daily life. Even walking just ten minutes three times a day can go a long way towards working up to the recommended goal of 150 minutes a week of moderate physical activity.

Innovations can make solar energy cheaper

Just imagine your window panes doubling up as a solar cell while still allowing you to look outside. A new technology developed by scientists at University of California makes this possible. Polymer solar cells are made of plastic-like material and are light weight as well as flexible.

They may also be cheap if produced in large volumes.

The cells produce energy by mainly absorbing infrared light, not visible light, making them 66 per cent transparent to the human eye.

Researchers used a photoactive plastic that converts infrared light into an electrical current, besides transparent conductor made of a mixture of silver nanowire and titanium dioxide nanoparticles instead of opaque metal electrode currently used.

Such solar panels could be used in smart windows or portable electronics, according to research published in journal ACS Nano. Scientists are also developing organic or plastic solar cells which will be light, semi-transparent, and cheap to produce.

Such cells could be printed on different surfaces using specialised printing and coating processes.

Drug companies often project exaggerated R&D costs to seek extended patents and other government sops. Not just this, they are actually spending just 1.3 per cent of their revenues on discovering new molecules while spending a quarter of their revenues on promotion and marketing, a new study published in British Medical Journal has revealed. The ratio of basic research to marketing is 1:19.